By Emily Rosenbaum, American Heart Association News

xavierarnau/E+ via Getty Images
(xavierarnau/E+ via Getty Images)

在感染COVID-19之前患有不受控制的高血压或糖尿病的人可能有更高的住院或使用呼吸机的风险, 一项新的研究还表明,如果糖尿病得不到控制,死亡风险会增加.

The study of nearly 1.5 million adults in the U.S. with COVID-19 is the largest of its kind, said lead author Dr. Sandra Jackson, 他是亚特兰大疾病控制和预防中心心脏病和中风预防部门的首席健康科学家. And unlike other studies, 这项新研究着眼于人们在感染冠状病毒之前对高血压和糖尿病的控制, rather than using measurements taken during COVID-19 illness.

“这些结果强调了慢性病控制对大流行防范的重要性," Jackson said.

The study, published Wednesday in the Journal of the American Heart Association, included people who had COVID-19 between March 2020 and February 2022. 总体而言,43%的患者患有高血压,12%患有糖尿病. Data on control rates was available for most of them.

与高血压得到最好控制的参与者相比, 高血压控制程度最低的人住院的几率要高出30%左右, 30% higher odds of receiving critical care, and 32% greater likelihood of needing a ventilator to help them breathe.

Among participants with diabetes, 糖化血红蛋白(一种监测血糖水平的血液测试)控制最低的人住院的几率要高出61%, 42% greater chance of receiving critical care, 12% higher likelihood of being on a ventilator, 与糖化血红蛋白水平控制得最好的人相比,死亡几率高出18%.

The researchers adjusted for age, race, smoking status and other factors that could have influenced the results, 但他们缺乏有关COVID-19疫苗接种状况的必要信息.

患有高血压或糖尿病的成年人可以与医生一起监测并有效治疗这些疾病, Jackson said. In addition, she said that "to help avoid serious illness from COVID-19, 高血压和糖尿病患者可以遵守疫苗接种建议,如果他们确实感染了COVID-19,可以寻求早期治疗."

The CDC recommends 5岁及以上的每个人都要接种最新的COVID-19疫苗,以预防COVID-19引起的严重疾病.

Dr. Sandeep Das, a cardiologist at UT Southwestern Medical Center in Dallas, said the new study adds to what's known about COVID-19 in the U.S.

“一个关键的优势是,它捕获了大量患者住院前的数据, thus allowing description of rates of hospitalization, ventilation and mortality, which are uncommon outcomes in the general COVID-infected population," said Das, who was not involved with the study.

“作者已经清楚地确定了一群COVID-19患者,他们的预后更差的风险更高, and this information can be valuable in informing public policy," he said. “尽管这项研究没有直接研究COVID-19预防或早期治疗策略的效果, these are good targets for future investigation."

2019冠状病毒病大流行扰乱了卫生保健服务和人们的日常卫生习惯,对慢性病管理造成了打击, 导致成年人获得预防性保健或参与已知促进高血压和糖尿病控制的行为的途径较少, the researchers wrote. In emphasizing the importance of disease management during a pandemic, 他们建议进行远程医疗预约以及教育和支持,以帮助人们更好地管理自己的病情.

American Heart Association statistics show nearly half of adults in the U.S. – about 122 million – have hypertension, 即最高读数为130毫米汞柱(收缩压)或最低读数为80毫米汞柱(舒张压). Yet only an estimated 1 in 4 has their high blood pressure under control. 与此同时,大约2900万成年人被诊断患有糖尿病,另有900万人被诊断患有糖尿病.7 million have diabetes but don't know it. 高血压和糖尿病都会增加患心脏病的风险, stroke and other serious health problems.

这项最新研究是在COVID-19的新住院人数从6人增加到6人的情况下进行的,479 in early July to 16,766 in early October, according to CDC tracking. 传染病专家和情景模型表明,今年秋冬季节可能会带来一场流感 moderate COVID-19 wave 与去年类似,但峰值可能比往年来得更早.

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